OBJECTIVETo investigate the clinicopathological features and prognosis of primary squamous cell carcinoma of the breast and to improve the diagnosis, treatment and prognosis of this disease.

METHODSThe clinicopathological data of 22 patients with primary squamous cell carcinoma of the breast treated in our hospital between January 1985 and January 2011 were retrospectively reviewed. The correlation between age, tumor size, axillary node status, treatment modality and prognosis was statistically analyzed.

RESULTSAll the 22 patients were female and their median age was 56 years.The average tumor diameter was 3.6 cm.The diagnosis was confirmed by histopathology. The positive rates of expression of ER, PR and HER-2 of the breast cancers were 9. 1%, 9. 1% and 33. 3%, respectively. In follow-up visits, recurrence or metastasis was found in 5 patients and they all died of it. The median overall survival of the 22 patients was 60 months and their overall 5-year survival rate was 73.6%. Univariate analysis showed that the tumor maximum diameter (P = 0.024) and axillary lymph node status (P = 0.022) were impact factors, while menopause, chemotherapy and radiotherapy were not. Cox multivariate analysis showed that the tumor size (P = 0.021) and axillary lymph node status (P = 0.037) were independent prognostic factors for primary squamous cell carcinoma of the breast.

CONCLUSIONSPrimary squamous cell carcinoma of the breast is a rare entity and lack of specific clinical features. Axillary node status is an independent prognostic factor.

Analysis of Variance ; Axilla ; Breast Neoplasms ; metabolism ; mortality ; pathology ; Carcinoma, Squamous Cell ; metabolism ; mortality ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Tumor Burden

BACKGROUND: Studies about the mechanism of laser occlusion on the varicose great saphenous vein are rare.OBJECTIVE: To explore the ultrastructural changes of the great varicose saphnous vein after it was occluded with laser.DESIGN: An observational study.SETTING: Laser Department of the General Hospital of Chinese PLA .PARTICI PANTS: There were 42 patients with varicose great saphenous veins that were occluded with laser in clinic of the General Hospital of Chinese PLA from January to April 2004. The inclusive criteria: There must be obvious vein tangles beneath the undystrophic skin at ankle without apparent thrombus inside the vein. The patients involved should be voluntary to take part in the study. Finally 9 patients were enrolled in this study.INTERVENTION: The great saphenous vein was intravenously occluded with laser of 810 nm and the working power was 12 W and the exposure time was 1 s. The occluded vein sample was taken out 3 hours after the occlusion.MAINOUTCOME MEASURES: The ultrastrncture of the occluded vein was observed histopathologically. Normal vein and prereatment varicose vein served as control.RESULTS: The normal vein wall can be divided into 3 layers: the internal layer was composed of the simple endothelial cells; the median layer was composed of the smooth muscle cells, elastic fibers and collagenous fibers; the external layer was composed of the loose connective tissues. However, the internal layer of the varicose vein was incomplete, and the endothelial cells were loosely connected. The smooth muscle cells became hyperplasic, hypertrophic or atrophic. The elastic fibers decreased in number in contrast to the increase of collagenous fibers. After laser occlusion, in the vein lumen there was a large number of blood cells. The platelets became flattened with pseudopods and adhered to collagenous fibers. The endothelial cells and smooth muscle cells near the lumen were damaged and the cytoplasma leaked and fused with extracellular matrix. Broken collagenous and elastic fibers could be seen near the lumen and some were observed in the lumen. There was no structure change in the external layer and adjacent elastic fibers and collagenous fibers.CONCLUSION: Laser occlusion damaged the internal layer and part of median layer of the varicose vein, caused aggregation of the blood cells in the lumen and promoted the adhesion of platelets to vein walls.

Objective To investigate the resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides and its resistance genes.Methods The minimal inhibitory concentrations (MICs) of seven antimicrobials (gentamicin, amikacin, tobramycine, netilmicin, neomycin, streptomycin and kanamycin) against 20 strains of multi-drug resistant Acinetobacter baumannii were detected by agar dilution method. Meanwhile, two resistance genes of aminoglycoside nucleotidyltransferase were amplified by PCR and vertified by DNA sequencer.Results It was found that MIC50 and MIC90 of gentamicin, amikacin, streptomycin and kanamycin in 20 strains of Acinetobacter baumannii were all above 1 024 mg/L, and their resistant rates were 95%, 95%, 100% and 90% respectively, while the resistant rates of tobramycin, netilmicin and neomycin were 85%, 90% and 40% respectively. Two aminoglycoside-modification genes ant(2″)-Ⅰ and ant(3″)-Ⅰ were detected in 20 strains, with 55% and 80% of positive rate respectively. The double positive rate of two resistance genes was 50%.Conclusion The resistance of multi-drug resistant Acinetobacter baumannii against aminoglycosides was closely associated with ant(2″)-Ⅰ and ant(3″)-Ⅰ genes.

Objective To identify the relationship between the clinical characteristics and prognostic factors in sequentially occurring primary cancers of the breast and ovarian.Methods Clinical and pathological data of 44 cases of successive primary cancers of the breast and ovarian in each single patient diagnosed in Tianjin Medical University Cancer Institute and Hospital from 2000 to 2013 were retrospectively analyzed.Results The median overall survival of all patients with double primary cancers of breast and ovarian was 264 months.3-year overall survival rate was 95.3％ and 5-year overall survival rate was 83.0％ respectively.32 patients were first diagnosed with breast cancer and 12 patients firstly suffered from ovarian cancer.The interval between breast cancer and ovarian cancer was 1-240 months (median 60 months).The staging of ovarian cancer (P =0.005) is the main prognostic factor.In patients firstly diagnosed breast cancer,age (P =0.025) and chemotherapy(P =0.010) were mainly associated with the interval between breast cancer and ovarian cancer.Age when first cancer diagnosed,tumor size of the breast and staging of ovarian cancer were mainly prognostic factors.Age when breast cancer diagnosed and chemotherapy were factors impacting the interval of breast cancer and ovarian cancer.Conclusions For patients with sequentially diagnosed primary cancers of the breast and ovarian cancer,late stage ovarian cancer predicts a poor prognosis.The interval in patients aged 50 and below suffering from secondary cancer is long.Proper chemotherapy for breast cancer seems to delay the occuring of ovarian cancer.

Objective:To improve the recognition, appropriate diagnosis, and treatment of breast cancer in women aged 25 years or less through their clinicopathological features, diagnosis, treatment, and prognosis. Methods:The clinicopathological data from 77 patients with breast cancer treated in our hospital between January 1995 and January 2010 were retrospectively reviewed. The correla-tion between age, lactation, tumor size, axillary node status, surgical approach, pathological stage, indicators of immunohistochemistry treatment modality, and prognosis was analyzed using statistical software. Results:All patients were female, and their average age was 22.94 ± 1.94 years. The diagnosis depended on pathological examination. In the follow-up visits, recurrence or metastasis was found in 27 patients, of which 18 died . The median overall survival was 39 months, and the median progression-free survival was 36 months. The 3 year overall survival rates of stagesⅠ,Ⅱ,Ⅲ, andⅣwere 100%, 92.44%, 59.97%, and 0, respectively. The 5 year overall sur-vival rates of the four stages were 100%, 86.84%, 59.97%, and 0, respectively. Univariate factor analysis showed that tumor size, axil-lary lymph node status, surgical approach, pathological stage, and estrogen receptor were impact factors, whereas lactation, progester-one receptor, human epidermal growth factor receptor-2, p53, molecular subtyping, chemotherapy, and radiotherapy were not. Cox mul-tivariate analysis showed that axillary lymph node status was an independent prognostic factor for breast cancer in women aged 25 years or less. Conclusion:Breast cancer in young women is rare and has unique characteristics in biological behaviors, diagnosis, prognosis, and other factors. Axillary lymph node status was an independent prognostic factor. The crucial factors in the treatment were diagnosis and on time and early-stage treatment.

Adjuvant treatment, which includes chemotherapy and endocrine therapy, for early breast cancer may impair bone den-sity, resulting in bone loss. The third generation bisphosphonate-zoledronic is an anti-resorptive agent that inhibits osteoclast-mediated bone resorption. This drug can be mainly used in the treatment of hypercalcemia caused by bone metastases of the cancer. The Zome-ta-Femara Adjuvant Synergy Trial revealed that immediate zoledronic acid and endocrine therapy not only prevents bone loss, but also reduces recurrence. The Austrian Breast and Colorectal Cancer Study Group-12 (ABCSG-12) also confirmed that zoledronic acid, when combined with endocrine therapy, could reduce the risk of cancer disease progression and death. Moreover, preclinical studies and clini-cal trials have demonstrated the synergistic antitumor effects of chemotherapy and zoledronic acid. Neo-adjuvant zoledronic acid to re-duce recurrence trials showed that the addition of zoledronic acid to adjuvant chemotherapy significantly reduced the risk of disease pro-gression and death in postmenopausal women more than five years postmenopause at the beginning of the study or over 60 years of age at the baseline. The ABCSG-12 subgroup analysis based on age (≤40 years or>40 years) also showed that zoledronic acid can signifi-cantly improve the prognosis in women who were over 40 years at the study entry. These results suggest that zoledronic acid administra-tion in patients with lowered estrogen levels (naturally or as a consequence of adjuvant treatment) easily exerts anti-tumor effects. How-ever, the optimal dose and duration of zoledronic acid requires further studies. More clinical trials should be performed to provide suffi-cient evidence to support the effectiveness of zoledronic acid in the treatment of early breast cancer.

Objective To investigate the clinical values of NT-proBNP in left ventricular enlargement(LVE) and left ventricular dysfunction(LVD) of the patients with essential hypertension(EH) to provide a diagnostic basis for their diagnosis .Methods Plas-ma NT-proBNP concentrations in 120 patients with EH and in 29 normal controls were measured ,then the echocardiography exami-nation was performed to determine the left ventricular ejection fraction ( LVEF) ,left ventricular end-diastolic diameter(LVEDD) , left atrium(LA) and left ventricular systolic diameter(LVSDD) .The correlation between plasma NT-proBNP with LVE and LVD was analyzed .The diagnostic accuracy of NT-proBNP was analyzed by using receiver operating characteristic (ROC) curve .Results There were no statistically significant differences in the aspects of age ,sex and serum creatinine between the EH group and con-trol group ,but plasma NT-proBNP level of the former was significantly higher than that of the latter .The NT-proBNP level in the patients with LVE was significantly higher than that in the patients with normal left ventricle (P<0 .05) .The NT-proBNP level in the LVD patients was significantly higher than that in the patients with normal left ventricular function (P<0 .05) .The plasma NT-p roBNP level was positively correlated with LA ,LVEDD and LVSDD(r=0 .518 ,0 .58 ,0 .48 ,P<0 .01) while negatively crrelated with LVEF(r= -0 .61 ,P<0 .01) .The ROC curve showed that when the NT-proBNP was set at 380 pg/mL ,the sensitivity and specificity of NT-proBNP for diagnosing LVE were 80 .6% and 72 .4% ;which for diagnosing LVD were 80 .8% and 77 .4% ,re-spectively .Conclusion NT-proBNP is closely correlated with multiple ultrasonic indicators reflecting the left ventricular function and its level can reliably reflect the left ventricular contraction function ,which can serve as the marker for screening LVE and LVD in the patients with EH .

Objective To investigate the combined detection of serum vascular endothelial growth factor (VEGF),squamous cell carcinoma antigen (SCC-Ag)and cytokeratin 19 fragment (CYFRA21-1)value in assessing the efficacy of chemotherapy in patients with advanced squamous cell carcinoma of the lung.Methods 60 cases of lung squamous cell carcinoma patients in January 2011 between June 2013 to be admitted to hospital were treated with gemcitabine plus cisplatin or carboplatin chemotherapy.Detected the levels of serum VEGF,SCC-Ag and CYFRA21-1 expression in 60 cases before and after 1 cycle of chemotherapy in patients using ELISA and immunoradiometric assay,and evaluated the efficacy evaluation with reference to RECIST criteria after 2 cycle of chemotherapy.Results Effective group serum VEGF and CYFRA21-1 levels were 413± 114 pg/ml and 14.7±9.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 272±131 pg/ml and 10.8±7.1 ng/ml,which decreased after chemotherapy (P<0.01).Progress group serum VEGF and CYFRA21-1 levels were 472±207 pg/ml and 18.9±17.6 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 537±219 pg/ml and 21.5±20.2 ng/ml,which increased after chemotherapy (P<0.01).Stable group serum VEGF CYFRA21-1 levels and were 419±246 pg/ml and 17.0±12.9 ng/ml;serum VEGF and CYFRA21-1 levels after one cycle of chemotherapy were 421±252 pg/ml and 16.8±11.7 ng/ml,which had no changes before and after treatment (P>0.05). Serum SCC-Ag levels before and after each treatment group difference was not statistically significant (P>0.05).Multiple regression analysis showed that serum VEGF,CYFRA2 1-1 levels and the efficacy of lung squamous were related changed (t=5.86,P<0.001;t=2.26,P=0.027),and there was no significant correlation between SCC-Ag levels changes and the effect of chemotherapy (t=1.52,P=0.133).Conclusion Serum VEGF and CYFRA21-1 expression level changes associat-ed with squamous cell carcinoma of the lung chemotherapy effect,which can advance understanding of the effect of chemo-therapy,combined with advanced squamous cell carcinoma detection of serum VEGF and chemotherapy assessment CY-FRA2 1-1 has a certain reference value.

Objective To investigate the values of serum vascular endothelial growth factor (VEGF) ,carcinoembryonic antigen (CEA) ,carbohydrate antigen 19-9 (CA19-9) and ferritin (SF) determination in assessing the efficacy of chemotherapy in patients with advanced gastric cancer .Methods Wedetermined the concentrations of serum VEGF ,CEA ,CA19-9 and SF for 85 patients with advanced gastric cancer ,before and after 1 cycles of chemotherapy and evaluated the the effect of chemotherapy after 2 cycle of chemotherapy .Results In effective group ,serum concentrations of VEGF ,CEA ,CA19-9 and SF significantly decreased after chem-otherapy cycle(P< 0 .05) ,serum VEGF and CEA concentrations significantly increased in progress group (P< 0 .05) ,serum VEGF ,CEA ,CA19-9 and SF concentrations in stable group and serum CA19-9 and SF concentrations in progress group did not change significantly(P> 0 .05) ,compared with those before chemotherapy cycle .Multiple regression analysis showed that serum CEA ,VEGF ,CA19-9 concentration changes correlated with chemotherapy efficiency ,while serum SF didn′t(t=1 .58 ,P=0 .119) . Conclusion Serum CEA ,VEGF ,CA19-9 concentration changes associated with gastric cancer chemotherapy efficiency ,which help predict the efficiency of chemotherapy .

Objective To explore the clinical features and prognostic factors of breast cancer during pregnancy and lactation.Methods A retrospective analysis was performed on 77 patients admitted to the Tianjin Cancer Hospital from January 2002 to December 2012.According to when the cancer was found,these patients were divided into the pregnancy group (n =23) and the lactation group (n =54).Survival rate was calculated by life table,Multivariate factors for survival were analyzed by COX proportional hazards regression model.Results The mean maximum diameter of the tumor was 5.9 cm,49 cases had axillary lymph node metastasis.Compared with the lactation group,the patients in pregnancy group had larger tumor diameter,the mean diameter was 6.8 cm (P =0.031).The median follow-up time was 39 months and 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were 52.6％ and 61.8％,respectively.Multivariate analysis showed that the independent factors of DFS and OS were breastfeeding and tumor size.Conclusions Diagnosis of breast cancer daring pregnancy and lactation were usually delayed and often in late TNM stage.Breastfeeding and tumor size are independent prognostic factors.